Ranitidin and Nosocomial Infection in Very Low Birth Weight Infants

Nosocomial infections increase mortality rate in neonates. Studies have attributed the use of H2 blockers as one of the various factors that increase the risk of nosocomial infections. To define the relationship between nosocomial infection and Ranitidine in very low birth weight (VLBW) infants admitted in the NICU of a tertiary care hospital. All VLBW infants admitted during the study period of 3 years from April 2008 to March 2011 were included. All relevant pre-and peri-natal data including all administered medications was collected from the case notes and documented on a pre-designed questionnaire. Rate of nosocomial infection (NI) had been compared between patients who were administered Ranitidine and those who did not receive this medication. During the study period, 564 VLBW infants were admitted in the NICU; 157, (27.8%) contracted nosocomial infections, 130 (82.8%) developed pneumonia, 21, (13.4%) had sepsis with positive blood cultures and 6 infants (1.1%) developed necrotizing enterocolitis. Factors remaining independently significant for development of NI after adjustment were as follows: RDS (P = 0.001. OR = 3.29; 95%CI = 1.64–6.6); CLD (P < 0.001. OR = 3.83; 95%CI = 2.06–7.11); anemia (P = 0.005. OR = 1.96; 95% CI = 1.23-3.13); use of Ibuprofen (P = 0.03. OR = 1.99; 95%CI = 1.06-3.74), and treatment with Ranitidine (P = 0.009, OR = 1.92, 95%CI = 1.18-3.12). Use of Ranitidine was associated with a significantly increased risk of nosocomial infections in VLBW infant.